Dermal sinus tract revealed by a central nervous system infection: 3 case reports

Abstract

Purpose
To remind spine local skin marks suggestive of a dermal sinus tract and to highlight the importance of early prophylactic excision of this lesion.
Methods:
Data from the medical records of three patients admitted for the management of a dermal sinus tract associated with a central nervous system infection were reviewed.
Results:
Two patients were male and one female aged of 11 months, 3 years and 11 months respectively. Presenting symptoms were neurological deficits with fever in two cases and recurrent meningitis in one case. MRI was suggestive of intradural abscess at the lumbar vertebral level with a dermal sinus tract in all cases. The abscess was drained and the tract was surgically excised. Neurological deficits remained in two cases.
Conclusion:
To avoid catastrophic neurologic consequences due to the infectious complications of a dermal sinus tract, this malformation must be detected by every pediatrician examining an infant, and early prophylactic surgery is obligatory.